WEEK 5 CLIN 1130 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
1. A nurse should be aware of safety measures to prevent personal injury when lifting or moving patients.
An appropriate principle to follow is:
a. bend at the waist for lifting.
b. tighten the stomach muscles and pelvis.
c. keep the weight to be lifted away from the body.
d. carry or hold the weight 1 to 2 feet above the waist.
Answer:
ANS: B Tighten the stomach muscles and tuck the pelvis; this provides balance and protects the back.
Bend at the knees; this helps to maintain the nurse's center of gravity and lets the strong muscles of the legs
do the lifting. Keep the weight to be lifted as close to the body as possible; this action places the weight in
the same plane as the lifter and close to the center of gravity for balance.
Question:
2. The most prevalent and debilitating occupational health hazard among nurses is:
a. footdrop.
b. pressure ulcers.
c. musculoskeletal disorders.
d. contractures.
Answer:
ANS: C Musculoskeletal disorders are the most prevalent and debilitating occupational health hazard
among nurses. Little improvement has been noted in the incidence of musculoskeletal injuries among
health care workers. In 1989, 4.2 lost-workday injury cases per 100 were reported; in 2000, 4.1 cases per
100 were reported. Plantar flexion contracture or footdrop is a complication seen in bedridden patients.
Pressure ulcers and contractures are complications that can develop in patients who do not maintain correct
body alignment.
Question:
3. The patient is an elderly male with severe kyphosis who is immobile from a stroke several years earlier.
He has been admitted for severe dehydration. The nurse must turn the patient frequently to prevent
complications of immobility. What does the nurse realize?
a. This patient should be turned onto his back for meals.
b. This patient may have to be turned more frequently than every 2 hours.
c. This patient may be allowed to remain in his favorite position as long as he doesn't complain of
discomfort.
d. Skin breakdown is not an issue for this patient.
Answer:
ANS: B Patients with underlying chronic conditions are at risk for skin breakdown and other hazards of
immobility and as a result require more frequent position changes. A patient with severe kyphosis cannot
lie supine or is unable to lift an object safely because the center of gravity is not aligned. Cluttered
hallways and bedside areas increase the patient's risk for falling. Dehydration or edema may require more
frequent position changes because patients are prone to skin breakdown.
, Question:
4. 4. Why does a nurse move a patient who has been confined to bed for a few days slowly from a sitting to
a standing position?
a. Fatigue
b. Muscle injury
c. Sensory disorientation
d. Orthostatic hypotension
Answer:
ANS: D A patient who has been immobile for several days or longer may be weak or dizzy or may develop
orthostatic hypotension (a drop in blood pressure) when transferred.
Question:
5. 5. A nurse is reviewing the patient assignment for the day. Of all the patients, which individual has the
greatest potential for injury during transfers?
a. Diabetes mellitus
b. Myocardial infarction
c. A cerebrovascular accident
d. An upper extremity fracture
Answer:
ANS: C Certain conditions increase a patient's risk for falling or potential for injury. Neuromuscular
deficits, motor weakness, calcium loss from long bones, cognitive and visual dysfunction, and altered
balance increase risk for injury. A diagnosis of diabetes mellitus, myocardial infarction, or upper extremity
fracture does not increase the patient's risk for injury to the same extent.
Question:
6. 6. To assist the patient to a sitting position on the side of the bed, what should the nurse do first?
a. Raise the height of the bed.
b. Raise the head of the bed 30 degrees.
c. Turn the patient onto the side facing away from the nurse.
d. Move the patient's legs over the side of the bed.
Answer:
ANS: B With the patient in supine position, raise the head of the bed 30 degrees; this decreases the amount
of work needed by the patient and the nurse to raise the patient to a sitting position. The bed should be in
the low position. The patient is turned to face the nurse after the head of the bed is raised 30 degrees. The
patient's legs are positioned over the edge of the bed after the head of the bed is raised and the patient is
turned to face the nurse.
Question:
7. 7. To transfer the patient who has normal weight bearing and upper body strength out of bed to a chair,
what should the nurse do?
a. Grab the patient under the axilla to lift.
b. Have the patient move forward with the weak side.
c. Have the patient put on shoes with nonskid soles.
d. Place the chair in a position 90 degrees opposite the bed.
CORRECT ANSWERS
Question:
1. A nurse should be aware of safety measures to prevent personal injury when lifting or moving patients.
An appropriate principle to follow is:
a. bend at the waist for lifting.
b. tighten the stomach muscles and pelvis.
c. keep the weight to be lifted away from the body.
d. carry or hold the weight 1 to 2 feet above the waist.
Answer:
ANS: B Tighten the stomach muscles and tuck the pelvis; this provides balance and protects the back.
Bend at the knees; this helps to maintain the nurse's center of gravity and lets the strong muscles of the legs
do the lifting. Keep the weight to be lifted as close to the body as possible; this action places the weight in
the same plane as the lifter and close to the center of gravity for balance.
Question:
2. The most prevalent and debilitating occupational health hazard among nurses is:
a. footdrop.
b. pressure ulcers.
c. musculoskeletal disorders.
d. contractures.
Answer:
ANS: C Musculoskeletal disorders are the most prevalent and debilitating occupational health hazard
among nurses. Little improvement has been noted in the incidence of musculoskeletal injuries among
health care workers. In 1989, 4.2 lost-workday injury cases per 100 were reported; in 2000, 4.1 cases per
100 were reported. Plantar flexion contracture or footdrop is a complication seen in bedridden patients.
Pressure ulcers and contractures are complications that can develop in patients who do not maintain correct
body alignment.
Question:
3. The patient is an elderly male with severe kyphosis who is immobile from a stroke several years earlier.
He has been admitted for severe dehydration. The nurse must turn the patient frequently to prevent
complications of immobility. What does the nurse realize?
a. This patient should be turned onto his back for meals.
b. This patient may have to be turned more frequently than every 2 hours.
c. This patient may be allowed to remain in his favorite position as long as he doesn't complain of
discomfort.
d. Skin breakdown is not an issue for this patient.
Answer:
ANS: B Patients with underlying chronic conditions are at risk for skin breakdown and other hazards of
immobility and as a result require more frequent position changes. A patient with severe kyphosis cannot
lie supine or is unable to lift an object safely because the center of gravity is not aligned. Cluttered
hallways and bedside areas increase the patient's risk for falling. Dehydration or edema may require more
frequent position changes because patients are prone to skin breakdown.
, Question:
4. 4. Why does a nurse move a patient who has been confined to bed for a few days slowly from a sitting to
a standing position?
a. Fatigue
b. Muscle injury
c. Sensory disorientation
d. Orthostatic hypotension
Answer:
ANS: D A patient who has been immobile for several days or longer may be weak or dizzy or may develop
orthostatic hypotension (a drop in blood pressure) when transferred.
Question:
5. 5. A nurse is reviewing the patient assignment for the day. Of all the patients, which individual has the
greatest potential for injury during transfers?
a. Diabetes mellitus
b. Myocardial infarction
c. A cerebrovascular accident
d. An upper extremity fracture
Answer:
ANS: C Certain conditions increase a patient's risk for falling or potential for injury. Neuromuscular
deficits, motor weakness, calcium loss from long bones, cognitive and visual dysfunction, and altered
balance increase risk for injury. A diagnosis of diabetes mellitus, myocardial infarction, or upper extremity
fracture does not increase the patient's risk for injury to the same extent.
Question:
6. 6. To assist the patient to a sitting position on the side of the bed, what should the nurse do first?
a. Raise the height of the bed.
b. Raise the head of the bed 30 degrees.
c. Turn the patient onto the side facing away from the nurse.
d. Move the patient's legs over the side of the bed.
Answer:
ANS: B With the patient in supine position, raise the head of the bed 30 degrees; this decreases the amount
of work needed by the patient and the nurse to raise the patient to a sitting position. The bed should be in
the low position. The patient is turned to face the nurse after the head of the bed is raised 30 degrees. The
patient's legs are positioned over the edge of the bed after the head of the bed is raised and the patient is
turned to face the nurse.
Question:
7. 7. To transfer the patient who has normal weight bearing and upper body strength out of bed to a chair,
what should the nurse do?
a. Grab the patient under the axilla to lift.
b. Have the patient move forward with the weak side.
c. Have the patient put on shoes with nonskid soles.
d. Place the chair in a position 90 degrees opposite the bed.
